Basic Information
Provider Information
NPI: 1255457628
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILLIER
FirstName: DAVID
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34581
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241581
CountryCode: US
TelephoneNumber: 5092417349
FaxNumber: 5092417628
Practice Location
Address1: 200 15TH AVE E
Address2:  
City: SEATTLE
State: WA
PostalCode: 981125260
CountryCode: US
TelephoneNumber: 2063263000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 07/30/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD00037316WAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
824333905WA MEDICAID


Home